Socrates Gustavo Roedan, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

274128 Issued in NY

Practice address

395 Fort Washington Ave
Suite 9
New York, NY 10033-6741

Phone

(212) 928-1400

NPI assigned

Apr 27, 2010

Last updated

Apr 11, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

Other, 2005

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/EAIGAA/Endpoint/EAIGAA

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Medicine and Rehabilitation Service PC

  • Physical Medicine & Rehabilitation Physician
  • New York, NY
  • NPI 1801158720
  NPD (past)
• SGR Medical Doctor P.C.

  • Obstetrics & Gynecology Physician
  • New York, NY
  • NPI 1992296677

  Internal Medicine

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1272326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554940800000",
    "number": "1861719122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "395 FORT WASHINGTON AVE STE 6&9",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100336741",
            "telephone_number": "212-928-1400",
            "fax_number": "212-923-5595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "395 FORT WASHINGTON AVE",
            "address_2": "SUITE 9",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100336741",
            "telephone_number": "212-928-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROEDAN",
        "first_name": "SOCRATES",
        "middle_name": "GUSTAVO",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-04-27",
        "last_updated": "2019-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "274128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julia Roe
• Kathy Gibson Roe, M.A., PSYA
• Patrick Roebke, PSY.D.
• Mary Frances Roebuck, PT,DPT
• Nancy E Roecklein, MS, ANP-BC
• Danielle Roeder, M.S. SLP-CCC, TSSLD
• Rebecca Roediger, M.D.
• Pamela Louise Roehrl, PHARM.D.
• Ryan Roels
• Laura Roemer

• Internal Medicine Physician in New York, NY
• Providers in New York, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.